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MCIs: Patients who ask about other patients


DMM4047

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Had this scenario come up recently. Motor vehicle versus motor vehicle, with three victims in the second vehicle: father, young child son, and infant son. Young child son was dead, but fire had started CPR which we continued for a few more minutes. I got father and infant son packaged and loaded it up in our truck (a second unit took the driver of the first vehicle), and we terminated resuscitation on the young child son on scene.

Father had seen us working on young child son, and was extremely distraught en route to the hospital. He repeatedly asked us about young child son and we just told him that another crew was still working on him. We let the hospital know and they had a chaplain give him the bad news--which, from what I heard, left him screaming loud enough for the whole hospital to hear it.

For the sake of infant son, and for the sake of allowing us and the hospital staff to do our jobs and take of father and infant son, we chose to withhold information that he had a right to know. Maybe it was right, maybe it wasn't, but I consider our first duty to be to tend to the health care needs of our patients, and like Dwayne said, while "always tell the truth" is a good rule, it really isn't always the best medicine--and in my opinion, the most important thing at the time was delivering good medicine.

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If memory serves, a crew should TRY to transport parents and children together, if it doesn't compromise patient care. Failing that, attempt to have them transported to the same recieving facility.

My answer to a patient asking about others also involved in the incident is, "I (we) will try and find out after we get you to the hospital, or have someone at the hospital advise you". I'll even stick to that answer, knowing there might be fatalities.

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The only question you need to ask yourself is this: Would you rather lie to the patient for your own good, and for their comfort, or would you tell them the truth?

I would warn you that some patients' outcomes may change depending on your answer. Dwayne makes a good point that it is sometime bad medicine to tell a "compromised" patient that their family is dead, or that they have killed someone.

Also know, that the person may be in a stage of grieving where they are looking for confirmation of what they already know. You may only be hampering the grieving process by lying. They may simply hover in a denial phase needlessly. What if they die on the pram without knowing what really happened?

Put yourself in the patient's shoes. Would you rather know, even if it killed or hurt you? Never lie because it makes your job easier.

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